Mental health treatment is still out of reach for many people. This, despite the revision of the Mental Health Parity Law, which requires health insurance companies to cover mental health treatment the same as they do for medical or surgical treatments.

President Obama may have meant well when he expanded mental health coverage for Americans, but psychiatrists are just not willing to accept patients due to hassles with insurance companies and low reimbursement costs. Also, most psychiatrists are private, and they don’t exactly want the extra work.

According to a new study published by JAMA Psychiatry and released online Wednesday, about 55% of psychiatrists accepted health insurance, compared with 90% of doctors in other specialties. The rate of psychiatrists accepting Medicare and Medicaid payments was also lower, with 55% accepting Medicare and 43% accepting Medicaid. This, despite the fact that after the Newtown massacre in 2012, mental health treatment is still not easier to access for many people who need it.

According to the JAMA study, the number of psychiatrists accepting health insurance declined between 2005 and 2010, specifically by 17%. The number of those accepting Medicare dropped to almost 20%, while those accepting Medicaid remained the same, around 43%.

In addition to fewer psychiatrists accepting health insurance, fewer medical students are entering the psychiatry field and more psychiatrists are retiring; about 55% of current psychiatrists are 55 and older. Another troubling statistic is the number of psychiatrists declining by 14% between 2000 and 2008. As psychiatrists retire and fewer newly minted psychiatrists take over, there will still be many positions that need to be filled. Mental health treatment is still out of reach for many.

One of the authors of the JAMA study, Dr. Tara F. Bishop, an assistant professor in the Department of Public Health and Medicine at Weill Cornell Medical College, reportedly says, “I must say we were surprised by the findings. No prior studies have documented such striking differences in insurance acceptance rates by psychiatrists and physicians of other specialties — primarily because no one has looked closely at the issue.”

The stigma of mental illness continues. The problem is so severe that one in five Americans have experienced mental health problems, and one in 20 have experienced severe mental illness, such as major depression, bipolar disorder and schizophrenia. More than 38,000 Americans commit suicide each year, a much higher number than homicides.

If it is hard getting mental health treatment in the beginning of mental illness or even while in the throes, imagine having no psychiatric treatment and then having to deal with the mental illness when it becomes full blown. This will cost our government more money in the long run, according to Dr. Bishop.

“We’re putting people in unsafe situations,” says Dr. Bishop. “They may have no options and have to go to the emergency room. It’s a pressing public health issue for our country.”

Compared with other medical specialties, psychiatric patients are usually in treatment longer. A typical therapy session is 50 to 60 minutes, usually over a prolonged period, maybe six months to a year, if the mental illness is not too severe. An investment in effective mental health treatment from the beginning is much needed, because as it is now, mental health treatment is still out of reach for many Americans.